O157 Outcomes of concurrent hiatus hernia repair with different bariatric surgery procedures: a systematic review

Abstract

Abstract Introduction Hiatus hernia (HH) are prevalent among patients with obesity. HH repair is often performed concurrently during bariatric surgery (BS), but a consensus on the safety and effectiveness of concurrent HH repair (HHR) and BS remains unclear. We, therefore, undertook a systematic review of the safety and effectiveness of concurrent HHR and BS through the measurement of multiple postoperative outcomes. Methods A comprehensive search discovered 17 studies relating to concurrent BS and HHR. BS procedures included laparoscopic Sleeve Gastrectomy (LSG), Roux-en-Y Gastric Bypass (LRYGB), and Adjustable Gastric Banding (LAGB). Extracted from these studies were pre- and post-operatives and measurements and outcomes. Results For LSG, 8 of 11 studies concluded concurrent procedures to be safe and effective with no increase in mortality. Reoperation rates however were increased with HHR, while GORD rates improved compared to LSG alone. For LRYGB, in all 5 studies, concurrent procedures were concluded to be safe and effective, with no increase in mortality, length of stay, readmission and reoperation rates. Higher complication rates were observed compared to LSG with HHR. Among LAGB studies, all 4 studies were concluded to be safe and effective with no adverse outcomes on mortality, length of stay and GORD rates. Reoperation rates from pouch dilatation and gastric prolapse were also observed to decrease. Conclusion Concurrent HHR with BS appears to be safe and effective. Assessment of BS warrants the consideration of concurrent HHR depending on specific patient case and the surgeon's preference.